POS1497-HPR FEASIBILITY OF A PHYSIOTHERAPIST LED, BEHAVIOUR CHANGE INTERVENTION TO IMPROVE PHYSICAL ACTIVITY IN PEOPLE WITH RHEUMATOID ARTHRITIS
Authors: L. Larkin, S. Mckenna, T. Pyne, S. Gallagher, L. Glynn, A. Fraser, B. A. Esbensen, N. Kennedy
Journal: Annals of the Rheumatic Diseases (2022)

Background Physical activity (PA) is an important component in the management of people with rheumatoid arthritis (RA) (1). Interventions incorporating Behaviour Change (BC) theory are needed to target physically inactive people with RA. The study Physiotherapist-led Intervention to Promote Physical Activity in Rheumatoid Arthritis (PIPPRA) was designed using the Behaviour Change Wheel (BCW) and a pilot study of feasibility undertaken (ClinicalTrials.gov Identifier: NCT03644160 ). Objectives To obtain reliable estimates regarding recruitment rates; participant retention; protocol adherence and possible adverse events, and to producing estimates of the potential effect sizes of the BC intervention on changes in outcomes of physical activity; fatigue; disability and quality of life. Methods Participants were recruited at University Hospital (UH) rheumatology clinics and randomly assigned to control group (physical activity information leaflet) or intervention group (four BC physiotherapy sessions in eight weeks). Inclusion criteria were diagnosis of RA (ACR/EULAR 2010 classification criteria), aged 18+ years and classified as insufficiently physically active. Ethical approval was obtained from the UH research ethics committee. Participants were assessed at baseline (T0), 8-weeks (T1), and 24-weeks (T2). Descriptive statistics and t-tests were used to analyse the data with SPSS v22. Results 320 participants were identified through chart review with direct contact then with people meeting the inclusion criteria at rheumatology clinics. Of the clinic attendees n=183 (57%) were eligible to participate and n=58 (55%) of those consented to participate. The recruitment rate was 6.4 per month and refusal rate was 59%. Due to impact of COVID-19 on the study n=25 (43%) participants completed the study (n=11 (44%) in intervention and n=14 (56%) in control). Of the 25, n= 23 (92%) were female, mean age was 60 years (sd 11.5). Intervention group participants completed 100% of BC sessions 1 &amp; 2, 88% session 3 and 81% session 4. No serious adverse events were reported. Secondary outcome measures data is Table 1. Table 1. Mean (sd) for secondary outcome measures in PIPPRA feasibility study Outcomes and instruments Intervention Control Baseline Mean (sd) Time 1 Mean (sd) Time 2 Mean (sd) Baseline Mean (sd) Time 1 Mean (sd) Time 2 Mean (sd) Physical Activity – self report (YPAS 1 ) 146.27 (193.73) 120.88 (70.80) 132.00 (70.65) 91.75 (85.86) 58.03 (50.61) 124.31 (69.75) Physical Activity – objective (Step Count) 32,616.91 32,190.00 27,793.33 30,476.15 42,117.25 34,288.77 (11,415.85) (9,291.57) (7,426.92) (12,642.97) (21,714.67) (17,677.90) Pain (VAS 2 ) 4.18 4.90 4.50 3.71 5.10 4.79 (2.40) (1.91) (1.90) (2.55) (2.77) (4.50) Disability (HAQDI 3 ) 0.85 0.94 1.03 0.71 0.71 1.52 (0.57) (0.57) (0.65) (0.56) (0.52) (0.69) Fatigue (BRAF MDQ 4 ) 18.18 14.82 (13.15) 18.55 (11.84) 15.71 (12.29) 13.93 (15.27) 20.21 (10.85) (8.98) Psychological Constructs (TPB 5 ) 22.00 19.91 (7.76) 20.27 (8.63) 21.79 (5.67) 15.50 (11.43) 25.36 (6.86) (4.84) Quality of Life (RA QoL 6 ) 15.18 14.73 (7.23) 17.09 (7.33) 18.43 11.50 (10.02) 14.86 (6.47) (6.08) (5.06) Sleep (PSQI 7 ) 11.55 8.50 9.91 10.21 9.09 10.14 (3.56) (3.27) (3.62) (3.47) (4.32) (4.42) 1 YPAS – Yale Physical Activity Scale 2 VAS – Visual Analogue Scale 3 HAQDI – Health Assessment Questionnaire Disability Index 4 BRAF MDQ - Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire 5 TPB – Theory of Planned Behaviour Questionnaire 6 RA QoL – Rheumatoid Arthritis Quality of Life Scale 7 PSQI – Pittsburgh Sleep Quality Index Conclusion The PIPPRA study designed using the BCW to improve promote physical activity was feasible and safe. This pilot study provides a framework for larger intervention studies and based on these findings a fully powered trial is recommended. References [1]Rausch Osthoff A, Niedermann K, Braun J, et al. (2018) EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Annals of the Rheumatic Diseases 77:1251-1260. Disclosure of Interests None declared